- Ochsner Health (Lafayette, LA)
- …as well as efficiently in high pressure situations. Preferred- Experience in Case Management or Utilization Review Business and Financial Knowledge as well as ... and applies hospital approved medical necessity criteria to review appropriate admissions , levels of care and continued stay. Documents completed reviews in… more
- McLaren Health Care (Mount Clemens, MI)
- …for the appropriate level of care; may include admission/transfer reviews, utilization reviews, and surgical schedule reviews. + Employee facilitates acute rehab ... admissions for those referrals that are appropriate for admission...network. Provides reporting trends and activity to the rehab management team to develops strategic initiatives for market development… more
- McLaren Health Care (Pontiac, MI)
- …for the appropriate level of care; may include admission/transfer reviews, utilization reviews, and surgical schedule reviews. 3. Employee facilitates acute rehab ... admissions for those referrals that are appropriate for admission...network. Provides reporting trends and activity to the rehab management team to develops strategic initiatives for market development… more
- Beth Israel Lahey Health (Plymouth, MA)
- …unit cost, 4) reducing readmissions. **Duties/Responsibilities:** **A. Utilization Management ** Performs review of anticipated admissions utilizing InterQual ... This role is structured around four major functions + Utilization Management + Care Coordination + Discharge...satisfaction with the discharge from the ED Prevents unnecessary admissions for social reasons Functions as a liaison… more
- Ventura County (Ventura, CA)
- …medical policy with the Health Care Agency Director and Insurance Administrator, Utilization Management staff and Quality Assurance Staff. + Participates, as ... surgical procedures, referrals, tests, medication approvals requiring authorization.) + Develops utilization management standards and guidelines for approval by… more
- Mount Sinai Health System (New York, NY)
- …limited to: a. Reviews all new admissions to identify patients where utilization review, discharge planning, and/or case management will be needed using ... **Job Description** **RN/Case Manager MSH Case Management FT Days** The Case Manager (CM) will...length of stay (LOS), improved efficiency, quality and resource utilization . Assignment will be by units/clinical areas of practice… more
- Beth Israel Lahey Health (Boston, MA)
- …patient delivery systems. Collects quality and variance data as well as utilization management . Utilizes clinical experiences and expertise in conjunction with ... rehabilitation, respiratory care, dietetic, Elder Care and other clinical services. 4. Utilization Management /Managed Care: * Coordinates and organizes a timely… more
- Logan Health (Kalispell, MT)
- Logan Health Wellness & Pain Management is proud to offer some of the most comprehensive pain and wellness care in the United States. Job Description Summary Logan ... Health Wellness and Pain Management is looking for an LCSW, LCPC or LMFT...Duties: + Triages referrals from providers and ensures on-going liaison occurs with stakeholders as applicable to assigned area(s).… more
- Catholic Health Initiatives (Omaha, NE)
- …physician serving the hospital through teaching, consulting, and advising the care management and utilization review departments, medical staff members, and the ... continued stay reviews + Assist with length of stay management and utilization of resources + Assist...quality control, and patient safety + Act as a liaison with payers to facilitate approvals and prevent denials… more
- Community Health Systems (Franklin, TN)
- …preferred **Knowledge, Skills and Abilities** + Strong knowledge of utilization management principles, payer requirements, and healthcare regulations. ... Summary** The Utilization Review Coordinator ensures efficient and effective management of utilization review processes, including denials and appeals… more